Local treatment in unresectable hepatic metastases of carcinoid tumors: Experiences with hepatic artery embolization and radiofrequency ablationReport as inadecuate




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World Journal of Surgical Oncology

, 3:75

First Online: 17 November 2005Received: 01 July 2005Accepted: 17 November 2005

Abstract

BackgroundHepatic metastases of carcinoid tumors cause incapacitating symptoms, but are usually diffuse and therefore unresectable. In this article we evaluate our experiences with local treatment techniques in the management of carcinoid patients with hepatic metastases and failing systemic treatment.

MethodsFifteen consecutive carcinoid patients 11 men and 4 women; median age 60 years; range 45–71 years were treated with either hepatic artery embolization HAE with Ivalon particles or radiofrequency ablation RFA percutaneously or intra-operatively. Follow-up evaluation was performed by CT scan and 24-hours urinary 5-HIAA excretions.

ResultsA total of 18 HAE-s was performed in 13 patients, while 10 lesions in 3 patients were treated with RFA. Median follow-up was 12.5 months 2 – 25 months. Median duration of symptoms was 22 months 8 – 193 months. Median overall decrease of 5-HIAA excretion 2 months after HAE was 32% with tumor regression on CT-scan in 4 patients 30% and improvement of symptoms with a median duration of 15 months in 3 of them 23%. Embolization led to fatal hepatic failure in one patient. The 3 patients treated with RFA showed a decrease of urinary 5-HIAA values of 34, 81 and 93% respectively, with tumor regression in all of them. Improvement of symptoms was reported in 2 patients up to 25 months.

ConclusionLiver embolization performed late in the clinical course had limited effect on symptoms and biochemical and radiological parameters. First experiences with RFA are favorable and might encourage to apply RFA more widely in metastatic carcinoid.

Electronic supplementary materialThe online version of this article doi:10.1186-1477-7819-3-75 contains supplementary material, which is available to authorized users.

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Author: Vincent Meij - Johanna M Zuetenhorst - Richard van Hillegersberg - Robert Kröger - Warner Prevoo - Frits van Coevorden - B

Source: https://link.springer.com/







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